Some determinants of body weight, subcutaneous fat, and fat distribution in 25-64 year old Swiss urban men and woman

The effect of type-2-diabetes-related vascular endothelial dysfunction on skin physiology and activities of daily living

A common factor contributing to organ damage in type 2 diabetes mellitus (T2DM) is impaired tissue blood flow caused by damage to vascular endothelial cells (VECs). Damage can occur even before the clinical diagnosis of diabetes. It can be caused by both a high average blood glucose concentration and/or large daily spikes in blood glucose. While much of the present literature focuses on the damage to VECs and organs from these large glucose excursions, this review will focus on the consequence of this damage, that is, how endothelial cell damage in diabetes affects normal daily activities (e.g., exercise, reaction to typical stimuli) and various treatment modalities (e.g.. contrast baths and electrical stimulation therapy). It is important to understand the effects of VEC damage such as poor skin blood flow, compromised thermoregulation, and altered response to skin pressure in designing diabetes technologies as simple as heating pads and as complex as continuous glucose monitors. At the simplest level, people with diabetes have poor circulation to the skin and other organs. In the skin, even the blood flow response to locally applied pressure, such as during standing, is different than for people who do not have T2DM. Simple weight bearing on the foot can occlude the skin circulation. This makes the skin more susceptible to damage. In addition, endothelial damage has far-reaching effects on the whole body during normal activities of daily living, including an impaired response to local heat, such as hot packs and contrast baths, and higher body temperatures during whole body heating due to impaired blood flow and a reduced ability to sweat. Finally, because of multiple organ damage, people with T2DM have poor balance and gait and impaired exercise performance.

Relation of environmental tobacco smoke to diet and health habits: variations according to the site of exposure

It has been postulated that the relationship of environmental tobacco smoke (ETS) exposure to cancer or cardiovascular diseases may be confounded by social class or diet because women exposed to ETS by their smoker spouse belong to lower social classes and have an unhealthy diet. In a population survey in Geneva, Switzerland, 914 female never-smokers were interviewed about sociodemographic factors, health habits including a semiquantitative food frequency questionnaire, and exposure to ETS according to the site (home, work, leisure). Compared to women unexposed to ETS, those exposed to ETS at work ate less fibers, cereals, vegetables, lean meat, had a lower intake of iron and beta-carotene, and had a lower total energy intake; women exposed during leisure time ate less cereals, drank less skim milk, and had a lower intake of complex carbohydrates. But the diet of women exposed at home did not differ from the diet of those unexposed to ETS. Thus, "living with a smoker" in Geneva does not necessarily imply adopting his health and dietary habits. We conclude that confounding factors of the association of ETS and disease vary according to site and populations and therefore should not be invoked as a systematic source of bias in all studies.

[Distribution of habits related to health in a female Canarian population]

BACKGROUND

To compare several anthropometric variables, obesity and some life-style (tobacco, coffee and alcohol consumption and physical activity during leisure time) in women 45 years old and older.

METHODS

From the 1991 electoral roll, we obtained a population of 1221 women aged more than 45 years living in the island of Gran Canaria. A questionnaire and a physical examination including weight and height with light clothes was performed in every woman. Obesity was defined according to the Quetelet index, and weight (in kg) divided by height (in m) at square.

RESULTS

Rural women aged more than 45 years old are heavier, have a larger corporal surface, have a higher Quetelet index, smoke less and do greater activity during leisure time than urban women the same age. We found no differences either in alcohol or coffee consumption.

CONCLUSIONS

There are statistically significant differences between women that live in rural and urban habitats. Anthropometric variables (weight, corporal surface, Quetelet index) show higher values in rural women than in urban ones. On the other hand, tobacco consumption and sadentarism have a higher prevalence in the urban women compared to rural ones.

Passive smoking, active smoking, and education: their relationship to weight history in women in Geneva

OBJECTIVES

This study was undertaken to determine the relationship of education and tobacco smoke to lifetime weight history in women.

METHODS

Information on passive smoking, active smoking, and weight history was collected from 928 women aged 29 to 74 years selected from the general population of Geneva, Switzerland. Multivariate analysis of variance was performed for weight, weight at age 20, and weight changes since age 20.

RESULTS

Education was inversely related to weight at age 20, current weight, and weight gain since age 20. The least educated group had a current weight of 4 kg more than the most educated group. Differences across smoking categories were small: passive smokers had the highest current weight (63.4 kg) and former active smokers had the lowest (60.4 kg). Weight gain since age 20 tended to be smaller in former and current active smokers (5.5 to 7.2 kg) than in passive smokers (8.3 to 10.4 kg) and those never exposed (9.1 kg).

CONCLUSIONS

In this sample, education was an important predictor of women's current weight and weight history. Passive and active smoking had little long-term effect on weight.

The association between body mass index and the relative frequencies of diseases in a sample of hospitalized patients

Body mass index (BMI) is known to differ among the various diseases, potentially due to etiologic causes, which can lead to bias in estimating the effects of other risk factors. The relationship between BMI and disease must be identified to control for this potential bias in epidemiological investigations. We used the data from our large hospital-based case-control study to analyze the difference in BMI (computed as kg/m2) by diagnosis, separately in males (n = 20,011) and females (n = 9,083) admitted to the hospital between 1977 and 1992. The difference in BMI between diagnoses is most clearly represented through the quartile distributions, whereas the mean tends to camouflage it. Although some associations between BMI and disease differed between the sexes, in general, fractures and diseases of the respiratory tract were associated with the lowest BMI and arthritis, cataract/glaucoma, and endometrial cancer with the highest BMI. Potential disease risk factors, including alcohol use, smoking, and education, showed a strongly negative and age a strongly positive association with BMI in females, but little or no association was found between BMI and these factors in males. The data presented provide information on the correlation between BMI and several diseases and the potential distortion of etiologic factors that can occur as a result of these correlations. The reported associations with BMI can be useful in the evaluation of independent risk factors or when selecting appropriate controls in epidemiological investigations of diseases.

Prevalence of malnutrition in alcoholic and nonalcoholic medical inpatients: a comparative anthropometric study

Available data on the nutritional status of alcoholics is controversial. The present study was conducted to assess the frequency of malnutrition in alcoholic inpatients. The objectives were to (1) compare anthropometric data of hospitalized alcoholic and nonalcoholic patients and (2) evaluate the association between alcoholism and protein-energy malnutrition. It was a cross-sectional comparative study including a stratified analysis to control for potential confounding factors. Alcoholics were identified as patients with a score from the Michigan Alcoholism Screening Test > or = 8 among patients admitted consecutively to the general wards of a department of internal medicine; they were matched for sex, age, and time of admission with nonalcoholic patients (Michigan Alcoholism Screening Test score < or = 4). Nutritional status was assessed using weight, height, midarm circumference, and tricipital skinfold thickness values, which were then used to determine the Quetelet body mass index and the mid-arm muscle circumference. The study took place in general wards of internal medicine in a 1000-bed city and teaching hospital in Lausanne, Switzerland. The participants were 93 alcoholic patients and 93 controls aged 20 to 75 years, admitted from September 1, 1988, to March 18, 1989. Alcoholics were characterized by a low rate of severe protein-energy malnutrition (< 5%); their average body weight was normal, similar to the weight of nonalcoholic inpatients, and not greatly influenced by the presence or severity of concomitant liver disease. However, tricipital skinfold thickness was lower in alcoholics than in nonalcoholics (8 mm vs 10 mm, p < .05, and 13 mm vs 20 mm, p < .01, in men and women, respectively).(ABSTRACT TRUNCATED AT 250 WORDS)

Overweight and coronary risk factors results from a western Austrian survey

Objectives of the study are to estimate prevalence of weight categories in a western Austrian population and to determine differences in primary coronary risk factors between weight categories in adults. The study population consists of 635 males and 693 females aged 25 to 64 years from the state Vorarlberg in western Austria. Age-standardized prevalence of body-mass-index 25.0 to 29.9 kg/m2 is 42.8% in men and 23.0% in women. The prevalence of a body-mass-index of 30.0 kg/m2 or more is 8.6% in men and 13.3% in women. Categories of relative weight correlated in both sexes significantly with all investigated risk factors, i.e. total cholesterol, HDL cholesterol, triglycerides, fasting blood glucose and systolic blood pressure. Significance remained in multivariate regression analysis in all parameters for both sexes, when controlling for age. Thus, the survey clearly shows the importance of relative weight as an indicator of elevated coronary risk and the importance of overweight for public health.